Upper endoscopy with biopsy
Facility: Ohio Valley Surgical Hospital
Billing Code: 43239 (CPT)
- CPT Billing Code: 43239
- Insurance Median: $894
- Cash Discount Price: $4,367
- vs. Medicare Baseline: 0.96x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $926.63 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Personify Health | $432 | 47% |
| Ngs Coresource | $432 | 47% |
| Meritain Heatlh | $432 | 47% |
| Geha | $432 | 47% |
| Mail Handlers | $432 | 47% |
| Mhbp | $432 | 47% |
| Genworth | $432 | 47% |
| Aetna | $432 - $894 | 47% |
| Meritain | $432 | 47% |
| Pacific Source | $432 | 47% |
| Nippon Life | $432 | 47% |
| Communicare Advantage | $894 | 96% |
| Molina | $894 | 96% |
| Wellcare By Allwell | $894 | 96% |
| Blue Cross Blue Shield | $894 - $7,170 | 96% |
| American Republic | $894 | 96% |
| Central States | $894 | 96% |
| Aarp Supplemental | $894 | 96% |
| UnitedHealthcare | $894 - $2,869 | 96% |
| Champus | $894 | 96% |
| Molina Dual McR | $894 | 96% |
| Cigna | $894 - $1,354 | 96% |
| Aultcare Primetime Health Plan | $894 | 96% |
| Bankers Life and Casualty | $894 | 96% |
| Wraparound Pl Supp | $894 | 96% |
| American Retirement | $894 | 96% |
| Mmoh | $894 - $4,586 | 96% |
| Molina McR+McD | $894 | 96% |
| Patient No Pay | $894 | 96% |
| Gateway Health Plan | $894 | 96% |
| American Continental Insurance | $894 | 96% |
| Molina Dual McR | $894 | 96% |
| Molina McR McD | $894 | 96% |
| Medigold | $894 | 96% |
| Bankers Fidelity | $894 | 96% |
| Prosperity Supplement | $894 | 96% |
| Aarp | $894 | 96% |
| Everest | $894 | 96% |
| Humana | $894 | 96% |
| Medicare (plans) | $894 - $4,367 | 96% |
| Molina McR | $894 | 96% |
| American Continental Life | $894 | 96% |
| Molina Marketplace | $894 | 96% |
| Self Pay Imaging | $894 | 96% |
| Devoted Health | $929 | 100% |
| The Health Plan | $938 | 101% |
| Employer Direct | $1,028 | 111% |
| Caresourse | $1,340 | 145% |
| Medicaid / KanCare | $1,340 | 145% |
| Caresource | $1,340 | 145% |
| Nalc | $1,354 | 146% |
| Healthgram | $1,354 | 146% |
| Unified Group | $1,354 | 146% |
| Samba | $1,354 | 146% |
| Sbma | $1,354 | 146% |
| Mmoh (Supermed) | $3,385 | 365% |
| Mmo Cin. HMO | $4,586 | 495% |
| Luminare Health | $6,551 | 707% |
| Ohio Health | $6,551 | 707% |
| Preferred Health | $6,551 | 707% |
| Medben | $6,551 | 707% |